Behavioral Health CQM Rule issues (multiple Diagnosis matching)

aethelwulffe wrote on Saturday, November 07, 2015:

OK…so you can add a diagnosis to a patient, and you can trigger a rule from that target. What if you require a long IF-OR list of diagnosis codes? For instance, any ICD10 F31.x code should trigger NFQ# 0110. Does that mean you need to add each and every diagnosis as a separate target? Can we use wildcards? What about NOT requirements? Frankly, I wouldn’t mind a hook in the rules to allow me to run a query.
Any suggestions?

fsgl wrote on Saturday, November 07, 2015:

Because 2014 CEHRT not yet achieved, the following is based on MU1.

The rule can have 1 diagnosis or the entire lot. It worked fine either way in the past.

mdsupport wrote on Saturday, November 07, 2015:

As noted in this post, the logic seems to treat codes as wildcards - always. So in the image posted by @fsgl, anything after line 1 (ICD9:250) is superfluous.

We had also posted an update long time ago that allowed wildcard for other items. Lack of interest in use of rules seems to suggest many practices are missing out on a great productivity tool to improve quality of care.

aethelwulffe wrote on Saturday, November 07, 2015:

Being that we use ICD10, and you have to use the code picker, if I choose F31.1, then erase the .1 part leaving only F31, will it match all F31 codes thereafter?

fsgl wrote on Saturday, November 07, 2015:

With the 3 fold increase in the number of CQM’s that are required for 2014 CEHRT, one would like to streamline preparation of each clinical rule with the minimum number of ICD codes.

If a practice uses only E11.9 for Diabetic Exam & H40.11X0 for COAG in the Fee Sheet, it is more likely the revelant data will be captured in the AMC report.

In a single specialty practice, billing will be slow & inefficient, if the clerk is constantly searching for a code. This increases the possibility of error in any exercise that requires a diagnosis code.

No reason to do all this work if it has no bearing on reimbursement.

We have no codes for eCQM’s at present to examine, therefore comments are speculative at best.

aethelwulffe wrote on Saturday, November 07, 2015:

What I am talking about is merely the behavior of the rule sets in regard to selecting a diagnosis code as a trigger (inclusive). If I really do need it to trigger on any of the F31.x codes as they are assigned to a patient in the issues system, must I put in each and every code, or will the system hit if I merely put in a partial match string?

mdsupport wrote on Saturday, November 07, 2015:

The rules engine has specific function for diagnostic codes which does ‘LIKE’ rather than exact match. From our limited experience in migrating some rules, it may be better to input “F31.” rather than “F31” - just to be safe. Try it out in demo for yourself.

aethelwulffe wrote on Saturday, November 07, 2015:

Thanks. I will go for it!